상행대정맥 종양혈전을 동반한 재발성 간세포암 환자의 F-18 FDG PET/CT소견

Detection of Superior Vena Cava Tumor Thrombus by F-18 FDG PET/CT in Recurrent Hepatocellular Carcinoma

  • 최승진 (인하대학교 의과대학 핵의학교실) ;
  • 김철수 (인하대학교 의과대학 내과학교실) ;
  • 변성수 (인하대학교 의과대학 방사선과학교실) ;
  • 이경희 (인하대학교 의과대학 방사선과학교실) ;
  • 현인영 (인하대학교 의과대학 핵의학교실)
  • Choi, Seung-Jin (Department of Nuclear Medicine, Inha University College of Medicine) ;
  • Kim, Chul-Soo (Department of International Medicine, Inha University College of Medicine) ;
  • Byun, Sung-Su (Department of Radiology, Inha University College of Medicine) ;
  • Lee, Kyung-Hee (Department of Radiology, Inha University College of Medicine) ;
  • Hyun, In-Young (Department of Nuclear Medicine, Inha University College of Medicine)
  • 발행 : 2006.10.31

초록

We report the case of a 64-year-old man with superior vena cava (SVC) syndrome due to tumor thrombus from recurrent hepatocellular carcinoma (HCC). He presented with new onset of facial swelling for 10 days. HCC was detected ten years ago. He has undergone repeated transcatheter arterial embolization (TAE) and chemotherapy. Chest computed tomography (CT) demonstrated tumor thrombus in the SVC extending to right atrium. He underwent whole body F-18 fluorodeoxyglucose(FDG) positron emission tomography/computed tomography (PET/CT) scanning for assessing the effect of TAE in HCC. F-18 FDG PET/CT showed increased uptake in the residual liver mass indicating viable tumor. There was another intense F-18 FDG accumulation in SUV extending to right atrium to suggest tumor thrombus. This case illustrates that F-18 FDG PET/CT is useful to identification of distant metastases as well as assessment of response to therapy in long-term survival HCC patients.

키워드

참고문헌

  1. Khan MA, Combs CS, Brunt EM, Lowe VJ, Wolverson MK, Solomon H, et al. Positron emission tomography in the evaluation of hepatocellular carcinoma. J Hepatol 2000;32:792-7 https://doi.org/10.1016/S0168-8278(00)80248-2
  2. Lin WY, Tsai SC, Hung GU. Value of delayed $^{18}F$-FDG-PET imaging in the detection of hepatocellular carcinoma. Nucl Med Commun 2005;26:315-21 https://doi.org/10.1097/00006231-200504000-00003
  3. Beadsmoore CJ, Cheow HK, Sala E, Lomas DJ, Gibbs P, Save V, et al. Hepatocellular carcinoma tumour thrombus in a re-canalised para-umbilical vein: detection by 18-fluoro-2-deoxyglucose positron emission tomography imaging. Br J Radiol 2005;78:841-4 https://doi.org/10.1259/bjr/37052159
  4. Kew MC. Hepatocellular carcinoma presenting with the superior mediastinal syndrome. Am J Gastroenterol 1989;84:1092-4
  5. Chen CH, Sheu JC, Huang GT, Lee HS, Yang PM, Tsang YM, et al. Recurrent hepatocellular carcinoma presenting with superior vena cava syndrome. Hepatogastroenterology 2000;47: 1117-9
  6. Nguyen SD. Pancreatic neuroendocrine tumor with portal vein tumor thrombus: PET demonstration. Clin Nucl Med 2005;30:628-9 https://doi.org/10.1097/01.rlu.0000174205.24252.ca
  7. Vasanawala MS, wang Y, Quon A, Gambhir SS. F-18 fluorodeoxyglucose PET/CT as an imaging tool for staging and restaging cutaneous angiosarcoma of the scalp. Clin Nucl Med 2006;31:534-7 https://doi.org/10.1097/01.rlu.0000233073.12599.0a
  8. Cheze-Le Rest C, Botton E, Robinet G, Conan- Charlet V, Bizais Y, Visvikis D. FDG PET in epithelioid hemangioendothelioma. Clin Nucl Med 2004;29:789-92 https://doi.org/10.1097/00003072-200412000-00003
  9. Miceli M, Atoui R, Walker R, Mahfouz T, Mirza N, Diaz J, et al. Diagnosis of deep septic thrombophlebitis in cancer patients by fluorine-18 fluorodeoxyglucose positron emission tomography scanning:a preliminary report. J Clin Oncol 2004;22:1949-56 https://doi.org/10.1200/JCO.2004.10.160